Liver diseases and SGOT/SGPT test pattern

Viral hepatitis and SGOT/SGPT test

Pattern of the SGOT/SGPT test pattern or the degree of SGOT/SGPT enzyme elevation in the blood is a good way of diagnosing different liver diseases. Different types of liver diseases give rise to different level of SGOT/SGPT enzyme test value. But these enzyme changes are not diagnostic but help in the process of diagnosis.

In most acute hepatocellular disorders, the SGPT is higher than or equal to the SGOT. An SGOT:SGPT ratio>2:1 is suggestive while a ratio >3:1 is highly suggestive of alcoholic liver disease. The AST in alcoholic liver disease is rarely >300 U/L and the SGPT is often normal. A low level of SGPT in the serum is due to an alcohol-induced deficiency of pyridoxal phosphate. The aminotransferases are usually not greatly elevated in obstructive jaundice. One notable exception occurs during the acute phase of biliary obstruction caused by the passage of a gallstone into the common bile duct. In this setting, the aminotransferases can briefly be in the 1000 to 2000 U/L range. However, aminotransferase levels decrease quickly, and the liver function tests rapidly evolve into one typical of cholestasis.

Liver disease	SGOT/SGPT test pattern
Gilbert’s syndrome	normal
Liver diseases with hemolysis	Normal (usually)
Viral hepatitis	>500 IU SGPT>SGOT
Drug hepatitis	>500 IU SGPT>SGOT
Acute hepatocellular Necrosis (heart failure)	>500 IU SGPT>SGOT
Chronic hepatocellular disorders	Elevated, but usually >300 IU
Alcoholic hepatitis	AST:ALT >2
Cirrhosis	AST:ALT >2
Obstructive jaundice	Normal to moderate elevation Rarely >500 IU
Infiltrative diseases (tumor, granulomata)	Normal to slight elevation
Intra- and extra hepatic cholestasis	Normal to moderate elevation Rarely >500 IU